Abstract
Abdominal pain is a frequent presentation to the Emergency Department and it is often difficult to find a clear diagnosis. This is a unique case of a woman with worsening abdominal pain over 2 days with no clear etiology despite extensive, repeat evaluations with eventual spontaneous resolution. The diagnosis of chemical peritonitis was established when the patient revealed an extremely rare mechanism of injury the night before presentation that has never been described previously. Access to the abdominal cavity through the uterus has been documented by retrograde flow during menses, and through vigorous insufflation during oral sex leading to pneumoperitoneum. Passage of an exogenous fluid through the same mechanism mimicking an acute abdomen has never been documented. This entity presents another possible explanation for the frequently encountered abdominal pain that after thorough work-up does not have a definitive diagnosis.
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